| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $112.20 | $112.20 | $134.90 | |
Oscar Health
| Professional | $114.82 | $165.96 | $245.47 | |
Wellcare
| Facility | $416.87 | $416.87 | $416.87 | |
Wellcare
| Professional | $630.96 | $630.96 | $630.96 |